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Breast cancer patients often participate in shared decision-making to select a treatment regimen from multiple options. However, dissatisfaction with treatment outcomes can lead to decision regret. We evaluated decision regret and physical and psychological well-being among breast cancer patients who underwent adjuvant radiotherapy and explored associations with patient, tumor, and treatment characteristics and symptoms.

This cross-sectional study involved retrospectively obtaining clinical data and data collected through interviews carried out within regular long-term medical aftercare. Decision regret was assessed using the Ottawa Decision Regret Scale, physical and psychological well-being were assessed using the PROMIS Global Health-10 questionnaire, and patients were also asked about their treatment outcomes and symptoms. The questionnaire was administered 14 months to 4 years after completion of radiotherapy.

Of the 172 included breast cancer patients, only 13.9% expressed high decision regret, with most patients expressing little or no decision regret. More decision regret was associated with volumetric modulated arc therapy, chest wall irradiation, use of docetaxel as chemotherapy, lymphangiosis carcinomatosa, arm or hand swelling, and lower psychological well-being.

Although most patients reported little or no decision regret, our findings identify several treatment characteristics that are associated with more decision regret. Our findings also suggest that psychological well-being influences patients’ satisfaction with therapy decisions, implying that practitioners should pay special attention to maintaining psychological well-being during shared decision-making and ensuring that psychological assessment and treatment is provided after cancer therapy to deal with the long-term effects of radiotherapy.